Vertigo risk factors: who gets dizziness and vertigo, and why

Dizziness and vertigo are not the same

Dizziness can make you feel lightheaded, woozy or unsteady on your feet. Vertigo is the feeling that you or the room is spinning even when nothing is moving (MedlinePlus). Both can get worse when you walk, stand up or move your head, and can come with nausea, vomiting, sweating, trouble walking or ringing in the ears (MedlinePlus).

A balance disorder is a condition that makes you feel unsteady or dizzy. The NIDCD says about 15 percent of American adults (33 million) had a balance or dizziness problem in 2008 (NIDCD).

Who is more likely to get dizziness and vertigo

Dizziness and vertigo can happen to anyone, but they are more common as you get older. As people age, they may have more health conditions and take more medicines, which raises the chance of dizziness (MedlinePlus). The NIDCD also says the risk of balance problems increases with age (NIDCD).

Common causes

MedlinePlus lists these common causes of dizziness and vertigo (MedlinePlus):

• a sudden drop in blood pressure
• dehydration
• getting up too quickly
• certain medicines
• inner ear problems, such as Meniere's disease or benign paroxysmal positional vertigo (BPPV), the most common cause of vertigo
• motion sickness
• migraines
• a head injury or ear surgery

Sometimes dizziness or vertigo is a symptom of another condition (MedlinePlus). The NIDCD adds ear infections, low blood pressure when you stand up too quickly, and problems with the bones, joints or eyes, such as arthritis or eye muscle imbalance. Many balance disorders start suddenly and with no obvious cause (NIDCD).

Inner ear conditions that cause vertigo

The NIDCD describes these common balance disorders (NIDCD):

• BPPV (positional vertigo): a brief, intense spell of vertigo set off by a change in head position, such as rolling over in bed or looking up. It happens when tiny calcium crystals in the inner ear move into the wrong place. It can follow a head injury or develop just from getting older.
• Labyrinthitis: an infection or inflammation of the inner ear, often linked to an upper respiratory infection such as the flu.
• Meniere's disease: spells of vertigo with hearing loss, ringing in the ear and a feeling of fullness in the ear. The cause is still unknown.
• Vestibular neuronitis: inflammation of the balance nerve, which can be caused by a virus.
• Perilymph fistula: a leak of inner ear fluid into the middle ear. It can follow a head injury, big changes in air pressure (such as scuba diving), physical exertion, ear surgery or chronic ear infections, and some people are born with it.
• Mal de debarquement syndrome: a rocking or swaying feeling, typically after a cruise or other sea travel.

Symptoms to watch for

The NIDCD lists dizziness or vertigo, falling or feeling as if you will fall, staggering when you walk, lightheadedness or faintness, blurred vision, and confusion or disorientation. Nausea, vomiting, changes in heart rate and blood pressure, and fear or anxiety can also occur (NIDCD). If you answer "yes" to questions such as "Do I feel unsteady?" or "Do I feel as if the room is spinning around me, even for a very brief time?", the NIDCD says to talk to your doctor (NIDCD).

Lowering the risk of falls and injury

Balance problems combined with weakness, slowness, tremor or stiffness raise the risk of falling and injury (NIDCD). The NIDCD suggests talking to your doctor about whether it is safe to drive and how to lower your risk of falling, avoiding walking in the dark, wearing low-heeled or walking shoes outdoors, and using a cane, walker or handrails if needed (NIDCD). For more, see fall risk factors and the fall risk check.

Diagnosis and treatment

Your provider will ask about your medicines and symptoms and may check your hearing, balance and how you walk. You may need an imaging test if a stroke or head injury is possible (MedlinePlus). Dizziness often gets better on its own; treatment depends on the cause and may include balance exercises and medicines (MedlinePlus). For BPPV, a series of simple head movements such as the Epley maneuver can help move the crystals back, and a vestibular rehabilitation therapist can help people who keep having symptoms (NIDCD).

Common questions

What is the most common cause of vertigo?

MedlinePlus names benign paroxysmal positional vertigo (BPPV) as the most common cause of vertigo (MedlinePlus).

Can vertigo be linked to hearing loss?

Yes, in some conditions. Meniere's disease causes spells of vertigo together with hearing loss, ringing in the ear and ear fullness (NIDCD). See hearing loss risk factors.

Can my medicines make me dizzy?

Yes. Certain medicines are a common cause of dizziness (MedlinePlus), and a doctor will first check whether another health condition or a medicine is to blame (NIDCD). Do not stop a medicine on your own; ask your provider or pharmacist.